Provider Demographics
NPI:1992051445
Name:ST. FRANCIS WOODS, LLC
Entity type:Organization
Organization Name:ST. FRANCIS WOODS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ AGENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEE-MCQUILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-989-2300
Mailing Address - Street 1:3507 N MOLLECK DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-1013
Mailing Address - Country:US
Mailing Address - Phone:309-688-0093
Mailing Address - Fax:309-687-3550
Practice Address - Street 1:3507 N MOLLECK DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-1013
Practice Address - Country:US
Practice Address - Phone:309-688-0093
Practice Address - Fax:309-687-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility